Procedures Performed in the Cardiac Catheterization Laboratory

Diagnostic procedures

Diagnostic cardiac catheterization:

A catheter is inserted through the skin (percutaneous) into an artery, usually in the upper thigh or wrist, and then is threaded through the body's arterial highway to the heart, where a special dye is injected into the coronary arteries to reveal any possible blockages.

Biopsy:

A diagnostic procedure to obtain a myocardial tissue sample from the ventricle of the heart aid in the detection of a disease process (i.e., myocarditis, cardiomyopathy, etc.) or to monitor rejection after heart transplant.

Interventional procedures

Atherectomy:

If the plaque found in an artery has hardened and calcified, a cardiologist can use a rotational atherectomy catheter -- an olive-shaped diamond burr which rotates at very high speed -- to pulverize the plaque into harmless microscopic particles that are washed away by the blood stream. A laser atherectomy device could also be used in a similar fashion.

A catheter with a balloon on its tip is passed through to a coronary blockage. The balloon is inflated, splitting the plaque and stretching the wall of the coronary vessel to allow more blood flow to the heart muscle.

Percutaneous Coronary Intervention (PCI):

PCI is a non-surgical procedure that uses catheters and tiny wires to treat narrowing (stenosis) of the coronary arteries of the heart found in coronary artery disease. It offers an alternative to bypass surgery and a treatment option for people with angina who have no other options.

Septal closure devices:

A wire mesh device made out of nickel and titanium (Nitinol) and filled with a polyester thread is used to non-surgically close defects in the atrial septum (the wall between the two top chambers of the heart). A patent foramen ovale (PFO) and atrial septal defect (ASD) are two of the common defects that are closed with this technique.

Stenting:

A stent is a small, metal mesh tube that is placed within a coronary artery after balloon angioplasty to prevent the artery from reclosing (restenosis). There are also drug-eluting stents coated with a special medication to further help prevent re-narrowing of the coronary arteries. Like other coronary stents, it is left permanently in the artery, and slowly releases a drug that prevents the build-up of tissue that leads to restenosis. Many clinical and anatomic factors go in to the decision as to which type of stent is best for you and will be discussed with you prior to your procedure.

Thrombectomy:

If the artery is noted to have loose debris within it, there are various types of catheters designed to remove the debris from within the artery prior to either angioplasty or stenting.